§ 9701. Definitions
As used in this chapter:
(1) “Advance directive” means a written record executed pursuant to section 9703 of this title, which may include appointment of an agent, identification of a preferred primary
care clinician, instructions on health care desires or treatment goals, an anatomical
gift, disposition of remains, and funeral goods and services. The term includes documents
designated under prior law as a durable power of attorney for health care or a terminal
care document.
(2) “Agent” means an adult with capacity to whom authority to make health care decisions
is delegated under an advance directive, including an alternate agent if the agent
is not reasonably available.
(3) “Anatomical gift” shall have the same meaning as provided in subdivision 5250b(3) of this title.
(4) “Capacity” means an individual’s ability to make and communicate a decision regarding
the issue that needs to be decided.
(A) An individual shall be deemed to have capacity to appoint an agent if the individual
has a basic understanding of what it means to have another individual make health
care decisions for oneself and of who would be an appropriate individual to make those
decisions, and can identify whom the individual wants to make health care decisions
for the individual.
(B) An individual shall be deemed to have capacity to make a health care decision if the
individual has a basic understanding of the diagnosed condition and the benefits,
risks, and alternatives to the proposed health care.
(5) “Clinician” means a medical doctor licensed to practice under 26 V.S.A. chapter 23, an osteopathic physician licensed pursuant to 26 V.S.A. chapter 33, an advanced practice registered nurse licensed pursuant to 26 V.S.A. chapter 28, subchapter 2, and a physician assistant licensed pursuant to 26 V.S.A. chapter 31 acting within the scope of the license under which the clinician is practicing.
(6) “Clinician orders for life-sustaining treatment” or “COLST” means a clinician’s order
or orders for treatment such as intubation, mechanical ventilation, transfer to hospital,
antibiotics, artificially administered nutrition, or another medical intervention.
A COLST order is designed for use in outpatient settings and health care facilities
and may include a DNR order that meets the requirements of section 9708 of this title.
(7) “Commissioner” means the Commissioner of Health.
(8) “Do-not-resuscitate order” or “DNR order” means a written order of the patient’s clinician
directing health care providers not to attempt resuscitation.
(9) “DNR identification” means a necklace, bracelet, or anklet identifying the patient
as an individual who has a DNR order.
(10) “Emergency medical personnel” shall have the same meaning as provided in 24 V.S.A. § 2651.
(11) “Guardian” means a person appointed by the Probate Division of the Superior Court
who has the authority to make medical decisions pursuant to 14 V.S.A. § 3069(c).
(12) “Health care” means any treatment, service, or procedure to maintain, diagnose, or
treat an individual’s physical or mental condition, including services provided pursuant
to a clinician’s order, and services to assist in activities of daily living provided
by a health care provider or in a health care facility or residential care facility.
(13) “Health care decision” means consent, refusal to consent, or withdrawal of consent
to any health care and includes consent to receive out-of-network services.
(14) “Health care facility” shall have the same meaning as provided in section 9432 of this title.
(15) “Health care provider” shall have the same meaning as provided in section 9432 of this title and shall include emergency medical personnel.
(16) “HIPAA” means the Health Insurance Portability and Accountability Act of 1996, codified
at 42 U.S.C. § 1320d and 45 C.F.R. §§ 160-164.
(17) “Informed consent” means the consent given voluntarily by an individual with capacity,
on his or her own behalf or on behalf of another in the role of an agent, guardian,
or surrogate, after being fully informed of the nature, benefits, risks, and consequences
of the proposed health care, alternative health care, and no health care.
(18) “Interested individual” means:
(A) the principal’s or patient’s spouse, adult child, parent, adult sibling, adult grandchild,
or clergy person; or
(B) any adult who has exhibited special care and concern for the principal or patient
and who is personally familiar with the principal’s or patient’s values.
(19) “Life sustaining treatment” means any medical intervention, including nutrition and
hydration administered by medical means and antibiotics, which is intended to extend
life and without which the principal or patient is likely to die.
(20) “Nutrition and hydration administered by medical means” means the provision of food
and water by means other than the natural ingestion of food or fluids by eating or
drinking. Natural ingestion includes spoon feeding or similar means of assistance.
(21) “Ombudsman” means:
(A) the State Long-Term Care Ombudsman or a representative of the Ombudsman’s Office,
as defined in 33 V.S.A. § 7501; or
(B) a representative of the agency designated as the Office of the Mental Health Care
Ombudsman pursuant to section 7259 of this title.
(22) “Patient’s clinician” means the clinician who currently has responsibility for providing
health care to the patient.
(23) “Principal” means an adult who has executed an advance directive.
(24) “Principal’s clinician” means a clinician who currently has responsibility for providing
health care to the principal.
(25) “Probate Division of the Superior Court designee” means a responsible, knowledgeable
individual independent of a health care facility designated by the Probate Division
of the Superior Court in the district where the principal resides or the county where
the facility is located.
(26) “Procurement organization” shall have the same meaning as in subdivision 5250b(22) of this title.
(27) “Reasonably available” means able to be contacted with a level of diligence appropriate
to the seriousness and urgency of a principal’s health care needs, and willing and
able to act in a timely manner considering the urgency of the principal’s health care
needs.
(28) “Registry” means a secure, web-based database created by the Commissioner to which
individuals may submit an advance directive or information regarding the location
of an advance directive that is accessible to principals and agents and, as needed,
to individuals appointed to arrange for the disposition of remains, procurement organizations,
health care providers, health care facilities, residential care facilities, funeral
directors, crematory operators, cemetery officials, Probate Division of the Superior
Court officials, and the employees thereof.
(29) “Residential care facility” means a residential care home or an assisted living residence
as those terms are defined in 33 V.S.A. § 7102.
(30) “Resuscitate” or “resuscitation” includes chest compressions and mask ventilation;
intubation and ventilation; defibrillation or cardioversion; and emergency cardiac
medications provided according to the guidelines of the American Heart Association’s
Cardiac Life Support program.
(31) “DNR/COLST” means a do-not-resuscitate order (DNR) or a clinician order for life-sustaining
treatment (COLST), or both.
(32) “Surrogate” means an interested individual who provides or withholds, pursuant to
subchapter 2 of this chapter, informed consent for a do-not-resuscitate order or a
clinician order for life-sustaining treatment.
(33) “Suspend” means to terminate the applicability of all or part of an advance directive
for a specific period of time or while a specific condition exists.
(34) “Mental health patient representative” means the mental health patient representative
established by section 7253 of this title.
(35) “Digital signature” means an electronic identifier that is intended by the individual
using it to have the same force and effect as a manual signature and that meets all
of the following requirements:
(A) uses an algorithm approved by either the National Institute of Standards and Technology
or by the Department of Health;
(B) is unique to the individual using it;
(C) is capable of verification;
(D) is under the sole control of the individual using it;
(E) is linked to data in a manner that invalidates the digital signature if the data is
changed;
(F) persists with the document and not by association in separate files; and
(G) is bound to a digital certificate.
(36) “Remote witness” means a witness who is not physically present when a principal signs
an advance directive. (Added 2005, No. 55, § 1, eff. Sept. 1, 2005; amended 2005, No. 215 (Adj. Sess.), § 332; 2009, No. 25, § 13; 2009, No. 119 (Adj. Sess.), § 4; 2009, No. 154 (Adj. Sess.), § 238a, eff. Feb. 1, 2011; 2011, No. 60, § 9, eff. June 1, 2011; 2013, No. 34, § 30a; 2013, No. 127 (Adj. Sess.), § 4, eff. May 10, 2014; 2013, No. 192 (Adj. Sess.), § 17; 2015, No. 23, § 47; 2015, No. 136 (Adj. Sess.), § 1, eff. Jan. 1, 2018; 2017, No. 113 (Adj. Sess.), § 112; 2017, No. 121 (Adj. Sess.), § 1, eff. May 3, 2018; 2021, No. 137 (Adj. Sess.), § 7, eff. July 1, 2022; 2023, No. 88 (Adj. Sess.), § 1, eff. April 1, 2024.)